title: MRI-guided biopsy and fine needle aspiration biopsy (FNAB) in the diagnosis of musculoskeletal lesions.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the diagnostic performance of magnetic resonance imaging (MRI) guided musculoskeletal biopsy and the value of fine needle aspiration biopsy (FNAB) when combined with histologic biopsy.
  
  
  METHODS
  A total of 172 biopsies were performed under MRI guidance, 170 were histologic biopsies. In 112 cases, a fine needle aspiration biopsy was also performed. In two cases, a stand-alone FNAB was performed. The diagnostic performance was evaluated retrospectively by comparing the histopathologic and cytologic diagnosis with the current or final diagnosis after at least one year of clinical and imaging follow-up. A 0.23 T open MRI scanner with an interventional stereotactic guidance system was used.
  
  
  RESULTS
  The overall diagnostic accuracy of MRI guided biopsy was 0.95, sensitivity 0.91, specificity 0.98, positive predictive value (ppv) 0.97 and negative predictive value (npv) 0.93. The diagnostic accuracy of trephine biopsy alone was 0.93, sensitivity 0.89, specificity 0.98, ppv 0.97 and npv 0.91 and accuracy for FNAB alone was 0.85, sensitivity 0.80, specificity 0.90, ppv 0.89 and npv 0.82.
  
  
  CONCLUSIONS
  MRI guidance is a feasible and accurate tool in percutaneous musculoskeletal biopsies. Fine needle biopsy is a useful low-cost supplement to histologic biopsy.
authors.affiliation: Department of Radiology, Oulu University Hospital, P.O. Box 50, 90029 OYS, Finland. Electronic address: pekka.kerimaa@ppshp.fi.
authors.forename: Pekka
authors.initials: P
authors.lastname: Kerimaa
authors.forename: Antti
authors.initials: A
authors.lastname: Marttila
authors.forename: Pekka
authors.initials: P
authors.lastname: Hyvönen
authors.forename: Risto
authors.initials: R
authors.lastname: Ojala
authors.forename: Elisa
authors.initials: E
authors.lastname: Lappi-Blanco
authors.forename: Osmo
authors.initials: O
authors.lastname: Tervonen
authors.forename: Roberto
authors.initials: R
authors.lastname: Blanco Sequeiros
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D001859:Bone Neoplasms / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D005387:Finland; D006801:Humans; D061705:Image-Guided Biopsy; D007223:Infant; D053783:Magnetic Resonance Imaging, Interventional; D008297:Male; D008875:Middle Aged; D019042:Muscle Neoplasms / Q000473:pathology*; D015995:Prevalence; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult
keywords: Biopsy; Interventional MRI; MRI guidance; Musculoskeletal; Tumor